Lessons from the Japanese by Terry Polanin, MSN, APN

Last summer I had the privilege of traveling to China and Japan with my husband who attended an international conference. I felt compelled to share some of my impressions of the Japanese culture, as we Americans can learn much from their healthy, gentle, well-ordered customs.

Our time in Japan was limited to Tokyo, one of the most modern cities in the world. We toured the city and took the “bullet train”, traveling about 200 mph, up to Mount Fuji. We were able to view many smaller towns outside of Tokyo, taking a small boat trip and gondola ride up a mountain. The people were friendly, clean, and very polite in welcoming us Americans. I reflected back to the early 1940s and the conflict, violence, and disruption that both our countries experienced to now, nearly 80 years later, our allegiance.

During our travels, I was continually in awe of the health of this society, and its culture of rich traditions grounded in gentleness, respect, and yet mixed with futuristic technologies. The Japanese people are lean- walking or biking most everywhere (other than public transportation) and they seem to be a peaceful, well-ordered society, appreciating the rich traditions of their forefathers.

The Japanese faith has 3 religions: Shinto, Buddhism, and Christianity. We had the opportunity to visit both a Buddhist and Shinto temple. Both temples had many rooms of ornate, gold architecture and “gods” which they worship. Shinto is the indigenous and oldest faith of the Japanese, as old as Japan. This religion is deeply engrained in the Japanese culture. Religious preaching is not common though the Japanese architecture and pop culture tend to utilize Shinto philosophy for inspiration. Shinto is about kami or sacred spirits. These sacred spirits or gods take on many forms such as animals, plants, lakes, trees, and rivers. Shinto views humans as basically good kami and evil in the world as bad kami. The whole purpose of the Shinto religion is to keep evil spirits away. We took part in two “purifications”—one was a pool to drink from (or just wash ones hands) for the protection of your physical health. The other, a ritual we performed, was to protect and promote emotional health.   Shintologists worship and appreciate nature with the belief that carrying symbols for good fortune and good health will provide good luck to their family and friends. The Japanese are a superstitious culture with many ornate shrines for various kami that they worship. The shrines and temples certainly projected a calm, peaceful presence that is appreciated in Japan by natives and tourists alike.

It’s no surprise to me, after observing the way Japanese eat and take care of themselves, that they not only age well, but experience profound longevity with the average age of death being 87 for females and 84 for males. The Japanese elderly are held in high esteem and highly respected into their senior years- another custom, I believe contributing to healthy aging. A popular book, “Japanese Women Don’t Get Old”, identifies the value of healthy aging in Japan and mentions eating breakfast as a contributing factor as well. Breakfasts and dinners are very similar and usually include many cooked (not fried) vegetables, grilled fish, white (not brown) rice, sushi and fruits. It was very rare to see any native in the area of Tokyo we visited that would be considered overweight or obese. It was also rare to see fast food restaurants, although the “Golden Arches” were in both China and Japan. In Tokyo, “fast food” vendors consisted of mostly small, unrefrigerated carts on the streets or in the open-air store fronts, often with meats (hip bones, etc.), vegetables, and “dumpling” stands.

Healthy aging in Japan can be directly contributed to their lifestyle.  They enjoy healthy, lean, non-processed diets, daily physical activity, rituals of spirituality, and meditative habits. They maintain well-ordered lives and educate youth to value the wisdom of the elders, and focus on family life.  We Americans could re-visit these habits and learn from the Japanese.


Terry Polanin, MSN, APN

Family Nurse Practitioner




Is Fruit the Foe? by Leslie Rusch-Bayer, RD, LDN, CPT

On a daily basis I am discussing weight loss strategies with women of all sizes. I am always surprised by the quantity of patients who have eliminated or strictly limit fruit intake because they believe fruit is causing weight gain or limiting weight loss. I understand the concern many people face regarding weight as the worldwide obesity rate has doubled since 1980. But is fruit causing the problem?

I have questioned many patients about why they consider fruit an unhealthy food. Most patients have unrealistic and false notions of “sugar” found in fruit. Many assume that because fruit does contain large amounts of simple sugars including glucose, fructose and sucrose, that consuming fruits would negatively impact weight. Not only is the chemical makeup of fruit misunderstood, but many highly publicized diets like ketogenic, high protein, and low glycemic/carbohydrate are often recommended and implemented incorrectly which often leave a body metabolically worse, than before the diet began.

Because of the popularity of the topic, I have decided to research the question “does fruit make us fat?” As a Registered Dietitian, it is my responsibility to present the facts using science-based research, not trendy theories or ideas.

A research article titled Paradoxical Effects of Fruit on Obesity reviewed and collaborated many years of research and shared statistics regarding fruit intake and obesity. The points below share what I believe to be the most significant statements made in the article.

Low fruit consumption is the fourth leading contributor to the global disease burden. Eliminating fruit from your diet may be increasing your risk of disease. Fruit contains many phytonutrients, which are proven to fight disease. Research has proven these nutrients cannot be replicated with the same ability to reduce disease in supplement/vitamin/medication form. Phytonutrients must be consumed through colorful fruits and vegetables. I truly believe that most individuals who are overweight are under nourished.

Increasing daily consumption of fruit inversely correlates to weight gain. Because fruit is low in calories, it is considered a very low energy-dense food. Most foods having gone through processing have more calories per serving than fruit. Fruit contains an abundance of water, which contains no calories. It takes much more fruit than an individual would ever eat in a day to have the same energy content as the processed food consumed in the same day. Most people who eat a regular allowance of fresh fruit lose weight.

Fruit reduces calorie consumption. By replacing processed foods with increased amounts of fruit, less calories are consumed because the unhealthy fat, additives and refined carbohydrates found in most processed foods are being replaced with considerable amounts of dietary fiber, nutrients and water.

Fruit contains anti-obesity effects. Vitamin, mineral and micronutrient deficiencies have been proven to have correlations with obesity. Fruit has shown to contain large amounts of these essential ingredients. Deficiencies can be resolved through natural or formulated resources, however, fruit provides the perfect ingredient list as provided by mother nature and is considerably less expensive than purchasing a supplement.

Fruit contains prolonged satiety. Satiety is the physiological process that tells us we are full. Fruit contains large quantities of dietary fiber that digests slowly by delaying gastric emptying, often allowing the body to feel full for a longer period of time.

Fruit positively affects gut microbial ecology. As stated by Hippocrates, “All disease begins in the gut.” The microbiome is a complex topic that is still evolving through research; however, we know that the gut contains many different strains of bacteria. Some strains drive gut ecology toward an anti-obese environment and some strains drive gut ecology toward an obese environment. It has been proven that diet is the main external source that can change the gut’s environment. Some research has shown that increasing fruit in children’s meals have increased the bacteria (Bacteriodetes) related to lean bodies. Another study showed the bacteria (Bacteriodetes) was found to be abundant in a research group who increased their fruit intake and lost weight.

How can you improve you or your families’ fruit intake?

  • Always choose fresh or frozen fruit.
  • Eat the fruit in its natural state. Do not always rely on “blending” fruit into smoothies. When this is done, the body eliminates its natural mastication process.
  • Do not focus on eating only a small selection of fruits. Bananas and pineapple do not independently cause obesity. Blueberries are not going to single-handedly turn you into a supermodel. Each fruit contains its own blueprint of vitamins, minerals, micronutrients, fiber and phytonutrients. By eliminating fruits, you are eliminating resources that may be reducing your risk of obesity and disease.
  • Eliminate or reduce the amount of processed fruits you consume. Think canned fruit, fruit cups, juice and dried fruit.
  • Do not focus on what time you eat fruit or what you should eat fruit with. FRUIT IS NOT THE PROBLEM.

Obesity and all diseases are multifaceted issues. No one whole, straight-from-the-garden food group causes obesity or diabetes. If you have concerns regarding how altering the food you eat can improve your weight, diabetes, gut health or just overall wellness, I encourage you to schedule an appointment with me or one of our providers. Fad diets, misinformation in the media, as well as other improperly informed professionals may be causing you harm with their recommendations instead of helping you to reach your own goals by using true, scientifically-proven and researched data. Next time you are at the grocery store look at the fruit section with a new perspective.

Leslie Rusch-Bayer


Cologuard® by Dr. Michele Couri, MD, FACOG, ABIHM

“Life is a one time offer, use it well.” ~UNKNOWN

Colon cancer is the second leading cause of cancer-related deaths. The risk of colon cancer increases dramatically after the age of 50, and 4 out of 5 people diagnosed with colon cancer have no prior family history of it. However, 1 in 3 adults over age 50 is not getting screened for colon cancer.   Any patient of mine age 50 and older can tell you that when they see me for their annual well woman exam, I ask them if they are “ready to get their colonoscopy done?” They look at me with that facial expression that needs no explanation. There is no doubt that people dread having a colonoscopy, mainly because they do not want to have to do the bowel prep that precedes the test.

So often when we are referring to cancer, early diagnosis is key to improved survival. When caught early, colon cancer is 90% curable. There is now a non-invasive screening test for colon cancer that is a safe and effective alternative to colonoscopy for patients, age 50 and older, at average risk for colorectal cancer.  The test whose brand name is Cologuard® is a test that detects abnormalities in the stool caused by DNA mutations typically present in colon cancer or precancerous polyps. These abnormal cells from colon cancer shed into the stool, and therefore can be detected by the Cologuard® test. Cologuard® is not intended to be used by patients who have an increased risk for colon cancer, have inflammatory bowel disease or a history of colon cancer or colon polyps.

Cologuard® is FDA-approved, and has a 92% sensitivity in detecting all stages of colon cancer. A positive result may indicate the presence of colorectal cancer or advanced polyps and should be followed up with a diagnostic colonoscopy. However, a positive result does NOT mean that you have colon cancer, as false positive results may occur. Cologuard® does require an order by your healthcare provider, making it available only by prescription. However, once it is ordered, a kit is shipped directly to your home. The kit has very detailed instructions for properly collecting the stool sample and includes a prepaid UPS shipping label.   After the lab work has been completed, the lab will contact your healthcare provider with the results. If your test results are negative, it is recommended that the test be repeated in 3 years. Conveniently, the Cologuard® test does not require any preparation: no fasting or dietary restrictions are necessary.

Medicare covers the Cologuard® test with no co-pays or deductible amounts. For some Medicare Advantage patients, prior authorizations may apply. Many major commercial insurers also cover it, and again, prior authorizations may apply. Out of pocket patient costs may range from $0 to $649. It is covered once every 3 years for people who meet the following conditions:

  • Between 50 and 85 years old
  • Have no signs or symptoms of colorectal disease including abdominal pain, blood in the stool, positive fecal occult blood test
  • At average risk of developing colorectal cancer – no personal history of precancerous polyps, colorectal cancer, Crohn’s Disease, Ulcerative Colitis; and have no family history of colorectal cancer or precancerous polyps or familial syndromes that increase the risk of colorectal cancer.

Patients learn of their results through their healthcare providers in as little as two weeks.  If you are interested in learning more about DNA stool testing for colon cancer, I recommend www.cologuardtest.com. Neither I nor anyone at the Couri Center has any financial interest in the company that manufactures Cologuard® Ask us at your next appointment if Cologuard® testing is appropriate for you.


To Your Health,

Dr. Couri

Nurturing Self-Care by Hope Placher, PA-C, IFMCP

I’ve been thinking a lot about a common phrase I hear from many of my patients: “It’s time to take care of myself again.”  I love hearing those words, but it’s easy to draw the conclusion that for a period of time, you may not have been caring for yourself at all! Have you been there? There’s the analogy we’ve all heard more times than we can count: you have to secure your own oxygen mask before you can assist others. Practicing self-care is much the same.

Generally speaking, self-care is engaging in activities and behaviors that have a positive effect on your mental and physical health. There is no one thing — or even a list of things — that encompasses self-care. It’s different for each person. However, in my opinion, the end goal should be the same: to reduce stress, preserve relationships, maintain a beneficial work/life balance, and nurture your mental and physical well-being.

It’s a bit like reversing the golden rule: treat yourself as compassionately as you treat others. I believe it involves some introspection in identifying your needs and taking the necessary steps to meet them. I personally struggle in this area. When I neglect the importance of caring for myself I tiptoe around the flames of burnout. My physical health and energy levels takes a hit and I feel emotionally withdrawn.

Over the past few months, I’ve compiled my own list of self-care habits that I am trying to incorporate at least once per week. Here are a few examples: a 20 minute exercise session, painting my nails, looking at old/forgotten photographs, relaxing in the sauna, going for a drive and singing to the radio (beware fellow commuters), looking in the mirror and engaging in positive self thoughts, and taking a day off of work for a mental health day. I think these seemingly small changes make a big impact in our well-being. During the holiday season and the months to come, I encourage you to compile your own list and starting taking steps to nurture your entire being.

Hope Placher, PA-C, IFMCP

Recipe: French Lentil & Vegetable Soup with Bacon

By Jennifer Segal

Servings: 6  Total Time: 1 Hour


3 slices bacon, finely chopped

1-tablespoon olive oil

1 large yellow onion, finely chopped

1 stalk celery, finely chopped

2 medium carrots, diced

3 cloves garlic, minced

1 14.5 oz. can diced tomatoes

6 cups organic chicken broth (Better Than Bullion)

1-cup French lentils

1/2 teaspoon dried thyme

2 bay leaves

1-teaspoon salt

1/4 teaspoon ground black pepper

2 tablespoons chopped fresh parsley


Fry the bacon in a large pot over medium heat, stirring frequently, until the fat is rendered and the bacon is crisp, 4-5 minutes. Add the olive oil, onions and celery and cook, stirring occasionally, until the onions are soft and translucent, about 5 minutes. Add the carrots and garlic, stirring constantly, and cook 1 minute more. Add the diced tomatoes (with their juices), chicken broth, lentils, thyme, bay leaves, salt and pepper and bring to a boil. Cover partially, reduce heat to low and simmer until the lentils are tender, 45-50 minutes. Discard bay leaves.

Use an immersion blender to purée the soup until the broth is slightly thickened, or to desired consistency. (Do not purée too much or the soup will get too thick, and you’ll lose the integrity of the lentils.) If you don’t have an immersion blender, transfer about 2 cups of the soup to a blender and purée until smooth, then return the blended soup to the pot. Garnish with fresh chopped parsley. (Note: The soup may thicken as it sits; thin with a bit of water if necessary.)